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Interesting consideration spare the nerves or not.

User
Posted 17 Sep 2022 at 08:24

Yesterday received my prostatectomy. As normal the surgeon came round to see me pre surgery. He was confident that he could spare the nerves on one side but did add an additional point. That sparing the nerves raises the level of risk of return. He put it this way if you cannot get an errection, or don't use it. Then it was worth considering removing the nerves as well and fat around the gland. This is the first time that this consideration had been discussed, although I guess its obvious. I had never seen this in any discussion on here about this point, which has to my knowledge always been spare the nerves if you can if not then unfortunately that is the way it has to be. 


The surgeon and the whole team were brilliant btw 

User
Posted 17 Sep 2022 at 20:13
I guess it is a relevant point, if you currently can't get erections (or possibly aren't bothered) then prospects are better not trying to spare nerves. There ought to be a similar discussion about fertility, since prostatectomy involves a form of vasectomy, the only way you would be able to father children is through frozen sperm.

But it highlights the way the surgeon's plans carry a certain risk, the precise situation and ease of operation aren't known in advance. In my case the decision was made to spare the nerves on one side - but when the pathology came back it turned out there was a small positive margin on that side and some cells of a higher grade than had been picked up on the biopsy. I have recently, six years later, needed salvage radiotherapy.
 
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